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Gluten-free foods

Around one in 100 people have coeliac disease, caused by a reaction to gluten, that can be treated by cutting the substance from a patient's diet. Once diagnosed as coeliac by a doctor, patients in most parts of the UK can receive gluten-free staple foods from a pharmacy through a prescription from a GP.

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Travel vaccines

Vaccines for typhoid, hepatitis A and cholera and a combined jab for diptheria, polio and tetanus are usually available free on the NHS.

The health service offers the vaccinations free of charge because they protect against diseases deemed to present the greatest risk to public health if brought into the country by travellers.

Some countries require visitors to be vaccinated against diseases such as yellow fever or meningitis prior to arrival, while travellers to some parts of the world are advised to have inoculations against a range of other diseases, including tuberculosis, hepatitis B, Japanese encephalitis and tick-borne encephalitis.

These are not usually available on the NHS and can cost around £50 for each dose.

Described as: Clinically effective but low priority

Potential saving: £31.3m

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The latest health and hospitals news

Co-proxamol

Co-proxamol is used for mild to moderate pain relief is a combination of two active ingredients, dextropropoxyphene and paracetamol, which is typically included as a lower 350mg dose compared with the standard 500mg dose of paracetamol when taken alone.

There is limited evidence suggesting co-proxamol is more effective at treating pain than a regular dose of paracetamol, for either acute or chronic use.

There have been previous concerns that the drug has been linked to suicides and poisonings and it was gradually phased out from wide use between 2007 and 2007.

Described as: Low clinical effectiveness

Potential saving: £8.3m

Omega-3 and fish oils

Naturally-occurring oils from certain breeds of fish such as salmon and mackerel have typically been prescribed to promote a healthy heart for patients at risk of heart disease.

The fatty acid omega-3 usually comes in capsule form and has been used to help prevent irregular heartbeats and reduce the risk of clotting by making the blood less sticky.

Historic concerns about prescribing omega-3 stem from limited evidence suggesting the fatty acid is effective in capsule form, and little to categorically suggest what a recommended adult daily intake should be.

Described as: Low clinical effectiveness

Potential saving: £5.6m

Doxazosin MR

Doxazosin are a series of drugs used to treat hypertension, but doxazosin modified release (MR) tablets are only believed to be effective for a very small number of patients.

This form of doxazosin cost the NHS £7 million last year.

Described as: Clinically effective but with a cheaper alternative

Potential saving: £7.1m

Fentanyl

Generally used in palliative care, fentanyl is a strong painkiller that comes as patches for terminally ill patients. In many cases morphine is considered easier and cheaper to prescribe, and is just as effective for end-of life care.

NHS England estimates it spent just over £10 million on the drug last year.

Described as: Clinically effective but with a cheaper alternative

Potential saving: £10.1m

Rubefacients

A series of muscle rubs used to relieve skeletal-muscular pain are under review for their effectiveness compared with other forms of muscular pain relief.

Described as: Low clinical effectiveness

Potential saving: £6.4m

Liothyronine

Liothyronine is a thyroid hormone used to treat certain thyroid conditions including hypothyroidism.

Only small numbers of patients are found to benefit from the drug, which is generally more expensive than other forms of thyroid medication.

In 2016 the NHS reported that the treatment cost the NHS approximately £20.8 million per year.

Described as: Clinically effective but with a cheaper alternative

Potential saving: £30.9m

Tadalafil

Certain uses of the drug tadalafil, which is variously used to help alleviate erectile dysfunction and lower urinary tract infections, may also be phased out under the plans.

There are concerns that the drug is not as effective as other erectile dysfunction medications, such as sildenafil, sold under the brand name Viagra.

Described as: Clinically effective but with a cheaper alternative

Potential saving: £10.5m

Lidocaine plasters

Lidocaine plasters are a large sticking plasters that contain a local anaesthetic, which is absorbed into the skin when the affected area is covered.

They tend to be used when pain only affects a certain patch of skin, but can often be bought over the counter more easily and cheaper than the cost of a standard prescription.